Conceitos atuais sobre equilíbrio sagital e classificação da espondilólise e espondilolistese

Tebet, Marcos Antônio

doi:10.1016/j.rbo.2013.04.011

Cited by 24 publications

(9 citation statements)

References 31 publications

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“…2 Untreated patients develop structural abnormalities in vertebrae, adjacent nerve roots and soft tissue, reflecting as low back pain along with radicular neurologic deficit and sagittal pelvic imbalance. 6,7 In recent few years, the presence of high pelvic incidence (PI) and sacral slope (SS) have been highlighted in the setting of degenerative spondylolisthesis (DS). With focus on predisposing role of these factors, 8,9 increasing pelvic tilt (PT) reimburses high PI as a compensatory mechanism.…”

Section: Introductionmentioning

confidence: 99%

Spinopelvic Alignment Parameters in Spondylolisthesis Patients Compared to Nonspondylolisthesis Patients

Alijani

Ramzannejad

Yousefzadeh-Chabok

et al. 2019

Indian Journal of Neurosurgery

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Objective We aimed at describing spin pelvic alignment features in patients with degenerative spondylolisthesis (DS), in comparison with other patients complaining of low back pain but no evidence of spondylolisthesis on standard standing lateral lumbosacral X-ray. Methods In this prospective descriptive study, patients with low back pain included in two groups of DS and non-DS patients, according to preoperative lumbosacral X-ray in standard standing lateral position. Patient’s demographic characteristics, as well as spinopelvic alignment parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), lumbar lordosis, and facet joint orientation, were collected. DS patients were compared with non-DS, age-matched control group. Results DS patients were significantly obese (p = 0.031) and had a high PI (56.39 ± 11.5), SS (38.28 ± 10.32), and PT (18.52 ± 9.11), (p = 0.00, 0.01, 0.04, respectively). Moreover, segmental lordosis at L2–L3, L3–L4, and L5–S1 levels demonstrated a significant increase (p < 0.05). Facet joints at L4–L5 level were located more sagittally (37.5 ± 7.07 vs. 40.71 ± 6.33). Conclusion PI, SS, and PT significantly increase in DS patients compared with non-DS group. Elevated segmental lordosis at high lumbar levels and sagittal orientation of facet joints were other features observed in DS patients.

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Section: Introductionmentioning

confidence: 99%

Spinopelvic Alignment Parameters in Spondylolisthesis Patients Compared to Nonspondylolisthesis Patients

Alijani

Ramzannejad

Yousefzadeh-Chabok

et al. 2019

Indian Journal of Neurosurgery

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“…[2][3][4][5][6][7][8] One of the consequences of the variations in sagittal deformities (spondylolisthesis) is the reduced capacity to use this compensatory balance mechanism. 3,9,10,11 The surgical treatment, performed with arthrodesis in situ and the use of autologous bone grafts in the transverse apophysis in patients with varying degrees of slippage, together with decompression of the spinal canal, has an arthrodesis consolidation failure rate of 20%. Patients with an angle of displacement due to slippage of more than 50% develop kyphotic deformity following posterior approach fusion attempts, so there have been innovations in alternative surgical procedures to resolve this problem.…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, the increase in radicular lesions characteristic of instrumented reduction from the posterior approach is avoided. 3,11,13,14 However, reconstruction of the anterior spine for surgical treatment of spondylolisthesis is recommended, with varying outcomes, but with lower incidence of nerve lesions. Recovery of disk height via posterior and anterior intervertebral lumbar fusion provides rigidity to the mobile segment being surgically treated.…”

Section: Introductionmentioning

confidence: 99%

“…Today, intervertebral cages are used for this, and they seem to favor anterior fusion and recovery of the height of the discal space as part of the reconstruction of the anterior spine; however, there remains the question of the approach to be used for this procedure, since there are reports that additional procedures are necessary. 3,[11][12][13][14] The natural history of listhesic disease of the lumbar spine includes changes in mechanical stability that promote mechanisms of corporal compensation. Once established, they cause structural disorders of the vertebrae, the nerve roots, and adjacent soft tissue that translate clinically into lower back pain associated with disabling radicular neurological deficit with clear evidence of the loss of sagittal lumbar alignment and of sagittal pelvic balance, which is treatable using surgical reduction techniques, fixation, and circumferential arthrodesis to correct the anomalies in the lumbopelvic sagittal plane resulting in a decrease in symptoms and an improvement in the quality of life of these patients.…”

Section: Introductionmentioning

confidence: 99%

“…Once established, they cause structural disorders of the vertebrae, the nerve roots, and adjacent soft tissue that translate clinically into lower back pain associated with disabling radicular neurological deficit with clear evidence of the loss of sagittal lumbar alignment and of sagittal pelvic balance, which is treatable using surgical reduction techniques, fixation, and circumferential arthrodesis to correct the anomalies in the lumbopelvic sagittal plane resulting in a decrease in symptoms and an improvement in the quality of life of these patients. [11][12][13][14] The objective of this study is to demonstrate the recovery of sagittal lumbar alignment and sagittal pelvic balance following surgical reduction of lumbar spondylolisthesis and to define the benefits of the surgical procedures of reduction and fixation of lumbar spondylolisthesis and of 360° circumferential arthrodesis from two approaches.…”

Section: Introductionmentioning

confidence: 99%

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Functional Disability, Sagittal Alignment and Pelvic Balance in Lumbar Spondylolisthesis

et al. 2016

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Objectives: To demonstrate the recovery of lumbar sagittal pelvic alignment and sagittal pelvic balance after surgical reduction of lumbar spondylolisthesis and establish the benefits of the surgery for reduction and fixation of the lumbar spondylolisthesis with 360o circumferential arthrodesis for 2 surgical approaches by clinical and functional evaluation. Method: Eight patients with lumbar spondylolisthesis treated with surgical reduction and fixation of listhesis and segmental circumferential fusion with two surgical approaches were reviewed. They were evaluated before and after treatment with Oswestry, Visual Analogue for pain and Odom scales, performing radiographic measurement of lumbar sagittal alignment and pelvic sagittal balance with the technique of pelvic radius. Results: Oswestry scales and EVA reported improvement of symptoms after treatment in 8 cases; the Odom scale had six outstanding cases reported. The lumbar sagittal alignment presented a lumbosacral lordosis angle and a lumbopelvic lordosis angle reduced in 4 cases and increased in 4 other cases; pelvic sagittal balance increased the pelvic angle in 4 cases and decreased in 3 cases and the sacral translation of the hip axis to the promontory increased in 6 cases. Conclusion: The surgical procedure evaluated proved to be useful by modifying the lumbar sagittal alignment and the pelvic balance, besides reducing the symptoms, enabling the patient to have mobility and movement and the consequent satisfaction with the surgery.

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Comparison of lumbar segmental stabilization and general exercises on clinical and radiologic criteria in grade‐I spondylolisthesis patients: A double‐blind randomized controlled trial

Mohammadimajd

Lotfinia

Salahzadeh

et al. 2020

Physiotherapy Res Intl

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ObjectivesThe effects of different physiotherapy protocols on patients suffering from grade‐I spondylolisthesis have been thus far examined in a limited number of clinical trials. Therefore, the main purpose of this study was to compare the effects of lumbar segmental stabilization and general exercises on clinical and radiologic criteria in grade‐I spondylolisthesis patients.MethodsThis study was a double‐blind randomized controlled trial (RCT) with a test–retest design and parallel groups. A total of 26 patients with grade‐I spondylolisthesis were thus randomly assigned to experimental group (13 patients, lumbar segmental stabilization exercises) and control group (13 patients, general exercises). Subsequently, pain, functional disability, kinesiophobia, translational motion, angular motion and slip percentage of the vertebra were investigated.ResultsOf the 120 people recruited in this study, only 26 patients were eligible. According to pre/post‐intervention comparison, a statistically significant decrease was observed in the experimental group in terms of pain (p = 0.000), functional disability (p = 0.004), kinesiophobia (p = 0.002), translational motion (p = 0.043) and angular motion (p = 0.011), but not for slip percentage (p = 0.122). Considering the control group, a statistically significant decline was reported for pain (p = 0.043) and functional disability (p = 0.002). However, no significant differences were found for other variables in the control group. With regard to inter‐group comparison, there was no statistically significant difference between the two groups regarding the given variables except for kinesiophobia (p = 0.040).ConclusionBoth lumbar segmental stabilization and general exercises led to reduction in pain and functional disability of patients with grade‐I spondylolisthesis. Therefore, lumbar segmental stabilization exercises seemed to be better than general ones with reference to improving kinesiophobia and intervertebral movements.

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Conceitos atuais sobre equilíbrio sagital e classificação da espondilólise e espondilolistese

Cited by 24 publications

References 31 publications

Spinopelvic Alignment Parameters in Spondylolisthesis Patients Compared to Nonspondylolisthesis Patients

Spinopelvic Alignment Parameters in Spondylolisthesis Patients Compared to Nonspondylolisthesis Patients

Functional Disability, Sagittal Alignment and Pelvic Balance in Lumbar Spondylolisthesis

Comparison of lumbar segmental stabilization and general exercises on clinical and radiologic criteria in grade‐I spondylolisthesis patients: A double‐blind randomized controlled trial

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